How much rates vary
Facilitymedian $417 · 10th to 90th $132 to $871Professionalmedian $102 · 10th to 90th $60 to $186
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $72.44 Median $131.83 Typical High $2,089.30 | Facility | None | $72.44 | $131.83 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $131.83 | Professional | None | $60.26 | $87.10 | $131.83 |
BCBS New Mexico Setting Facility Modifier None Typical Low $147.91 Median $524.81 Typical High $812.83 | Facility | None | $147.91 | $524.81 | $812.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $138.04 | Professional | None | $60.26 | $100.00 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Facility | None | $537.03 | $537.03 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $186.21 | Professional | None | $66.07 | $107.15 | $186.21 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $97.72 Typical High $162.18 | Professional | None | $19.50 | $97.72 | $162.18 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $602.56 | Facility | None | $114.82 | $218.78 | $602.56 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $186.21 | Professional | None | $79.43 | $114.82 | $186.21 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,318.26 | Facility | None | $199.53 | $275.42 | $1,318.26 |
United Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $199.53 | Professional | None | $93.33 | $134.90 | $199.53 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $36.31 Typical High $66.07 | Professional | 52 · Reduced service | $28.18 | $36.31 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $26.30 | Professional | 53 · Discontinued | $11.22 | $14.45 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $53.70 Typical High $100.00 | Professional | 54 · Surgery only | $42.66 | $53.70 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.72 Typical High $19.95 | Professional | 55 · Aftercare only | $8.51 | $10.72 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.24 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.62 | $7.24 | $13.18 |
Where New Mexico sits
The same service costs 12.9 times more in Colorado than in Maine. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $2,408ME $187
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.